Individual provider Active NPI

Dominique Anne Dickey

  • Behavior Technician
  • Ontario, CA
National Provider Identifier
1417678970
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
3669 E Happy Paseo Unit 176
Ontario, CA 91761
Phone
(909) 247-8756
NPI assigned
Sep 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

3669 E Happy Paseo Unit 176
Ontario, CA 91761

Mailing address

3669 E Happy Paseo Unit 176
Ontario, CA 91761-4106
Phone (909) 627-0520

Other practice location 1

1650 Spruce St
Riverside, CA 92507-7402
Phone (909) 247-8756

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1417678970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3669 E HAPPY PASEO UNIT 176",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917614106",
            "telephone_number": "909-627-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3669 E HAPPY PASEO UNIT 176",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "91761",
            "telephone_number": "909-247-8756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Spruce St",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925077402",
            "country_code": "US",
            "telephone_number": "909-247-8756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKEY",
        "first_name": "DOMINIQUE",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-02",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.